This article explores rural–urban disparities in the treatment of head and neck cancer at a single institution, including data gathered during the COVID-19 pandemic.
Trends in treatment, outcome, and disease progression among rural and urban patients vary for a large number of diseases. This article, published in the Journal of Radiotherapy in Practice, analyzes trends in head and neck cancer patient populations over the past 5 years, with an emphasis on the past 2 years to highlight the effect of the COVID-19 pandemic on existing disparities. The study used a retrospective chart review to identify patients who received consultations and were then treated with at least one fraction of radiation therapy at a single institution, with either palliative or curative intent.
The study relied on demographic information including hometown, distance from the cancer center, insurance information, and type of appointment (telehealth or in-person). Rurality was determined using rural–urban continuum codes. A total of 490 head and neck cancer patients were treated at the center from 2017 to 2021. There were no significant trends in patient population regarding travel distance or rurality, and roughly 20–30% of patients lived in rural areas, with about 30% commuting 50 miles or more for radiation treatment. A majority of patients (68%) relied on public transportation, and a small percentage of these (4%) were not insured. Telehealth visits were uncommon prior to 2019, but rose in 2020 and 2021 to five and two visits, respectively.
These data show that head and neck cancer patients persistently seek treatment, despite rurality and the need to travel significant distances or take public transportation for care. This includes treatment received during the COVID-19 pandemic, during which patients continued to access treatment. The authors note that providers should continue to be aware of disparities that exist in the rural population in order to address them and provide more equitable care.
Nguyen, M., Derouen, J., Cantrell, J., Johnston, A., Vidal, G., Schutz, A., . . . Henson, C. (2023). Rural disparities in head and neck cancer from 2017 to 2021: A single institution analysis. Journal of Radiotherapy in Practice, 22, E43. doi:10.1017/S1460396922000127